Kencing manis semasa mengandung (gestational diabetes) is high blood sugar that starts during pregnancy and usually goes away after birth. It is common in Malaysia, where about 1 in 4 mothers in a 2022 national survey had it. It usually causes no symptoms, so Malaysia's Ministry of Health recommends an oral glucose tolerance test (OGTT) for women with risk factors and for those aged 25 or older. Most women with well-controlled gestational diabetes have healthy babies. Diet, activity and, if needed, metformin or insulin help, and you need a diabetes check after the birth. This guide explains the test, the numbers, what to eat, and what happens after delivery.
Apa itu kencing manis semasa mengandung?
Gestational diabetes (diabetes gestasi) is high blood sugar (glucose) that develops during pregnancy. During pregnancy, higher levels of pregnancy hormones can interfere with insulin, the hormone that keeps blood sugar in the normal range. Usually the body makes more insulin to keep up, but in some women it cannot make enough, and blood sugar rises (ACOG). Genes and extra weight may also play a role (NIDDK). It can happen at any stage of pregnancy, but is more common in the second or third trimester, and it usually goes away after giving birth (NHS).
It is different from type 1 or type 2 diabetes that you already had before pregnancy. Some women who are diagnosed in pregnancy had mild diabetes before and did not know; for them, it does not go away after birth (ACOG). For type 1 and type 2 diabetes, see our guide to kencing manis (diabetes).
How common is it in Malaysia? In the National Health and Morbidity Survey (NHMS) 2022, 27.1% of mothers with a child under 2 had gestational diabetes during their pregnancy, compared with 6.5% who had high blood pressure.
Siapa lebih berisiko?
Any pregnant woman can develop gestational diabetes, and it can happen in women with no risk factors (ACOG). Malaysia's Clinical Practice Guidelines (CPG) on diabetes in pregnancy list these as risk factors:
- a body mass index (BMI) above 27;
- gestational diabetes in a previous pregnancy;
- a parent, brother or sister with diabetes;
- a previous baby who weighed more than 4 kg;
- a previous unexplained stillbirth, a baby with certain birth defects, or a baby whose shoulders got stuck at birth;
- sugar in the urine (glycosuria 2+ or more) on two occasions;
- current pregnancy problems such as high blood pressure, too much amniotic fluid, or taking steroid medicines.
Risk also rises with age, which is why the Malaysian guideline recommends testing all pregnant women aged 25 or older, even with no other risk factors (CPG, 2017). ACOG adds being physically inactive and having PCOS, and notes that women of Asian descent are among those more often affected.
Tanda-tanda: biasanya tiada simptom
Gestational diabetes does not usually cause any symptoms; most cases are found through blood tests during pregnancy (NHS). If blood sugar gets very high, some women notice (NHS):
- feeling more thirsty than usual;
- needing to pee more often than usual;
- a dry mouth;
- tiredness;
- blurred eyesight;
- genital itching or thrush (see our guide to gatal faraj (vaginal itching)).
Some of these are common in any pregnancy, so they are not necessarily a sign of gestational diabetes (NHS). Because it is usually silent, do not skip your screening tests at the klinik kesihatan.
Ujian OGTT di Malaysia: bila dan bagaimana
Malaysia's Ministry of Health guideline recommends a 75 g oral glucose tolerance test (OGTT) (CPG, 2017):
| Who | When to test |
|---|---|
| Women with any risk factor listed above | At booking (the first antenatal visit) or as early as possible; if normal, repeat at 24 to 28 weeks |
| Women aged 25 or older with no other risk factors | At 24 to 28 weeks of pregnancy |
The guideline says that, ideally, all pregnant women should be screened, but where resources are limited, screening is focused on women at risk. A random blood sugar test or HbA1c alone is not a good enough test for gestational diabetes (CPG, 2017).
What happens during an OGTT
- You do not eat or drink for 8 to 10 hours beforehand, usually overnight, although you can usually drink water; check with your clinic if you are not sure (NHS).
- A blood sample is taken in the morning, then you drink a glucose drink (NHS).
- You rest for 2 hours, and another blood sample is taken to see how your body handles the glucose. The whole test takes about 2 hours (NHS).
If you are pregnant, register early at your klinik kesihatan so that your risk can be checked and the test planned. For other early pregnancy checks, see our guide to tanda-tanda mengandung.
Bacaan gula: diagnosis dan sasaran
These are the numbers used in Malaysia's guideline (CPG, 2017):
| Result | |
|---|---|
| Gestational diabetes (OGTT) | Fasting plasma glucose 5.1 mmol/L or higher, or 2-hour result 7.8 mmol/L or higher |
| Possible diabetes from before pregnancy | Fasting glucose 7.0 mmol/L or higher, or random glucose 11.1 mmol/L or higher with symptoms; confirmed with a second test |
| Target when checking at home: fasting or before meals | 5.3 mmol/L or lower |
| Target 1 hour after a meal | 7.8 mmol/L or lower |
| Target 2 hours after a meal | 6.7 mmol/L or lower |
If you have gestational diabetes, you will be shown how to check your blood sugar with a finger-prick meter, when to test, and how to share your results with your care team (NHS). Women on insulin or tablets should keep their blood sugar above 4.0 mmol/L to avoid low blood sugar (CPG, 2017). Your own targets may differ, so follow your doctor's advice.
Kesan kepada ibu dan bayi
Most women with gestational diabetes have otherwise normal pregnancies with healthy babies (NHS). But if blood sugar stays high, more sugar passes to the baby, who can grow larger than usual (ACOG). Possible problems include (NHS; ACOG):
- a large baby, which can make birth harder and make induction or a caesarean more likely, and can cause heavy bleeding or tears for the mother;
- too much amniotic fluid (polyhydramnios), which can cause premature labour; see our guide to air ketuban;
- premature birth, before 37 weeks;
- pre-eclampsia, a condition that causes high blood pressure in pregnancy;
- low blood sugar, jaundice or breathing problems in the baby after birth;
- stillbirth, though this is rare.
The good news is that the risks can be reduced if gestational diabetes is found early and well managed (NHS). You will have extra antenatal checks and growth scans; Malaysia's guideline recommends a growth scan every 4 weeks from 28 to 36 weeks (CPG, 2017). Contact your doctor if you notice a change in your baby's movements (ACOG).
Makanan untuk ibu mengandung kencing manis
Changing what you eat is the first step, and you should be referred to a dietitian (NHS). Malaysia's guideline recommends a carbohydrate-controlled meal plan that suits your culture and needs (CPG, 2017). General advice (NHS; ACOG):
- Eat regularly, usually 3 meals a day, and do not skip meals. ACOG says 3 meals and 2 to 3 small snacks a day are often recommended, including a snack at night.
- Choose slow-release (low glycaemic index) starchy foods and watch your portion of rice, noodles and bread.
- Eat plenty of vegetables and some fruit each day.
- Choose lean protein, such as fish, chicken, tempeh or tauhu.
- Avoid sugary foods and drinks. You do not need a completely sugar-free diet, but swap cakes and biscuits for fruit, nuts or seeds. Fruit juice and some "no added sugar" drinks can also be high in sugar.
Malaysia's guideline includes a glycaemic index (GI) list of common local foods (CPG, 2017):
| Lower or medium GI (better choices) | Higher GI (eat less) | |
|---|---|---|
| Rice and grains | Barley, basmati rice, brown rice, parboiled rice, red rice | White rice, glutinous rice (pulut), jasmine rice, instant porridge, sago |
| Bread and breakfast | Wholegrain bread, muesli, oatmeal, chapati, idli | White bread, roti canai, cornflakes, rice crackers |
| Noodles | Spaghetti, udon | Fried mee hoon, fried rice noodles, kuey teow, fried macaroni |
| Drinks and dairy | Plain milk, low-fat milk, unsweetened soy milk, yoghurt | Teh tarik, sweetened condensed milk, ice cream |
| Fruit | Apple, orange, mango, plum, banana, papaya | Watermelon, lychee |
| Beans | Lentils (dhal), chickpeas, baked beans, mung beans |
The guideline's sample menu for a woman of normal weight uses meals such as 2 ladles of rice (preferably low-to-medium GI) with half a fish cooked as asam rebus or soup, baked tempeh or tauhu, vegetables and a piece of fruit, with plain water (CPG, 2017). Ask your dietitian how much is right for you. For more on Malaysian meals, see our guide to nasi putih.
Drann does not recommend any supplement, herbal product or "ubat kencing manis" for gestational diabetes. Talk to your doctor before taking anything.
Senaman dan berat badan
Physical activity lowers blood glucose, so regular exercise can help manage gestational diabetes (NHS). Malaysia's guideline says structured moderate exercise during pregnancy lowers the risk of gestational diabetes and reduces weight gain, with no harm to mother or baby. Safe examples include brisk walking, swimming, stationary cycling, low-impact aerobics and modified yoga or pilates, for at least 20 to 30 minutes on most days (CPG, 2017).
- ACOG suggests 30 minutes of moderate activity on at least 5 days a week, and a 10 to 15 minute walk after each meal for better blood sugar control.
- Tell your doctor before starting an activity you have not done before (NHS). Some women should not do aerobic exercise, for example if they have bleeding, placenta praevia after 26 weeks, ruptured membranes or high blood pressure in pregnancy (CPG, 2017).
Gaining too much weight, or gaining it too fast, can make blood sugar harder to control (ACOG). Ask your doctor how much weight gain is right for you.
Ubat: metformin dan insulin
If diet and exercise do not bring your blood sugar to target within 1 to 2 weeks, or if it is very high when you are diagnosed, you may need medicine (NHS; CPG, 2017):
- Metformin, a tablet. In Malaysia, the guideline says it should be prescribed after consultation with specialists. Side effects can include feeling sick, stomach cramps and diarrhoea (NHS).
- Insulin injections, given with a small pen. Insulin does not cross the placenta (ACOG). It may be needed if metformin is not enough or not suitable, if fasting glucose is 7.0 mmol/L or more at diagnosis, or if the baby is very large or there is too much amniotic fluid (NHS; CPG, 2017). Insulin can sometimes cause low blood sugar, with shakiness, sweating or hunger, so you will be taught how to treat it (NHS).
Blood sugar often rises as pregnancy goes on, so your medicine may need to change (NHS). Needing medicine does not mean you have failed; it is a normal part of care for many women.
Bersalin dan selepas bersalin
Timing of birth. Malaysia's guideline suggests that women with gestational diabetes on diet alone and with no complications give birth before 40 weeks, women on tablets or insulin between 37 and 38+6 weeks, and those with complications before 37 weeks. The method of delivery is decided for each woman (CPG, 2017). Most women with gestational diabetes can have a vaginal birth (ACOG).
After birth. Feed your baby as soon as possible, within 30 minutes, and then every 2 to 3 hours until your baby's blood sugar is stable; your baby's blood sugar will be checked a few hours after birth (NHS). Most women can stop their insulin immediately after delivery (CPG, 2017).
Long-term checks. Gestational diabetes greatly increases your risk of diabetes in your next pregnancy and later in life; between 15 and 70 percent of women who had it develop diabetes later (ACOG). Malaysia's guideline recommends (CPG, 2017):
- an OGTT 6 weeks after delivery, and a yearly diabetes test if it is normal;
- breastfeeding for at least 3 months, or longer, which is linked to a lower risk of diabetes;
- a healthy diet, regular activity and losing extra weight gained in pregnancy.
Tell your child's doctor that you had gestational diabetes, because children of mothers who had it have a higher risk of overweight and diabetes (ACOG). If you plan another pregnancy, get checked for diabetes first (NHS); see our guide to cara cepat hamil. A US study also found that gestational diabetes was linked to a higher risk of hand and wrist problems after birth, such as De Quervain and carpal tunnel syndrome (Smith et al., 2025).
Puasa Ramadan
Malaysia's guideline says pregnant women with diabetes should be strongly advised against fasting during Ramadan, while recognising that some may wish to observe the fast. A local study found that many women on certain insulin regimes were able to fast without low blood sugar, but this depends on each woman. If you wish to fast, talk to your doctor before Ramadan (CPG, 2017).
Frequently asked questions (FAQ)
Apa itu kencing manis semasa mengandung (what is gestational diabetes)?
Gestational diabetes (diabetes gestasi) is high blood sugar that develops during pregnancy and usually goes away after giving birth. It happens when your body cannot make enough insulin to meet the extra needs of pregnancy, because pregnancy hormones make insulin work less well (NHS; ACOG). It can happen at any stage but is more common in the second or third trimester (NHS). It is common in Malaysia: in the 2022 national survey, 27.1% of mothers with a child under 2 had gestational diabetes during their pregnancy (NHMS 2022).
Siapa perlu buat ujian OGTT semasa mengandung (who needs an OGTT in Malaysia)?
Malaysia's Ministry of Health guideline recommends a 75 g oral glucose tolerance test (OGTT) at your first antenatal visit if you have a risk factor, such as a BMI above 27, gestational diabetes before, a parent, brother or sister with diabetes, a previous baby over 4 kg, sugar in your urine (2+ or more) on two occasions, or high blood pressure in pregnancy. If the first test is normal, it is repeated at 24 to 28 weeks. If you are 25 or older with no other risk factors, the test is done at 24 to 28 weeks (CPG Management of Diabetes in Pregnancy, 2017).
Berapa bacaan OGTT untuk kencing manis semasa mengandung (what OGTT result means gestational diabetes)?
Under Malaysia's guideline, gestational diabetes is diagnosed if your fasting blood glucose is 5.1 mmol/L or higher, or your 2-hour result after the glucose drink is 7.8 mmol/L or higher. A fasting level of 7.0 mmol/L or more, or a random level of 11.1 mmol/L or more with symptoms, suggests diabetes that was there before pregnancy, which needs a second test to confirm (CPG, 2017). Your doctor will explain your own results.
Ibu mengandung kencing manis kena makan apa (what should I eat)?
Eat regular meals and do not skip meals, choose slow-release (low glycaemic index) carbohydrates, eat plenty of vegetables and some fruit, choose lean protein such as fish, and avoid sugary foods and drinks (NHS). Malaysia's guideline lists brown rice, red rice, parboiled rice, basmati rice, barley, oats, wholegrain bread, chapati, lentils and chickpeas as lower or medium glycaemic index choices, and white rice, glutinous rice, roti canai, fried noodles, teh tarik and sweetened condensed milk as higher glycaemic index foods (CPG, 2017). You do not need a completely sugar-free diet, and a dietitian can plan meals that suit you (NHS).
Kencing manis semasa mengandung bahaya untuk bayi ke (is it dangerous for my baby)?
Most women with gestational diabetes have otherwise normal pregnancies and healthy babies (NHS). Without good control, it can cause problems such as a large baby, which can make birth harder and make induction or a caesarean more likely, too much amniotic fluid, premature birth, pre-eclampsia, and low blood sugar or jaundice in the baby after birth; stillbirth is rare (NHS). Keeping your blood sugar in the target range reduces these risks (NHS; ACOG).
Kencing manis semasa mengandung hilang selepas bersalin ke (does it go away after birth)?
It usually goes away after birth, but it raises your risk of gestational diabetes in a future pregnancy and of type 2 diabetes later in life (NHS). ACOG says between 15 and 70 percent of women who had gestational diabetes develop diabetes later. Malaysia's guideline recommends an OGTT 6 weeks after delivery, and a yearly diabetes test after that if it is normal. Breastfeeding for at least 3 months and keeping active are also encouraged to reduce your risk (CPG, 2017).
Ibu mengandung kencing manis boleh puasa (can I fast in Ramadan)?
Malaysia's guideline says pregnant women with diabetes should be strongly advised against fasting during Ramadan, but recognises that some may wish to fast. If you want to fast, talk to your doctor before Ramadan so they can check whether it is safe for you and adjust any medicine (CPG, 2017).
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. If you are pregnant, follow the screening and treatment plan from your doctor or klinik kesihatan.
References
- Clinical Practice Guidelines: Management of Diabetes in Pregnancy (2017) — Ministry of Health Malaysia (MaHTAS)
- National Health and Morbidity Survey (NHMS) 2022: Maternal and Child Health fact sheet — Institute for Public Health, Ministry of Health Malaysia
- Gestational diabetes — NHS
- Gestational diabetes: treatment — NHS
- Gestational diabetes — American College of Obstetricians and Gynecologists (ACOG)
- Gestational diabetes — National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- Smith GB, et al. Incidence and risk factors for soft tissue hand and wrist conditions in pregnancy and postpartum. J Hand Surg Glob Online. 2025;7(5):100778
